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Cosmetic Surgery Thailand
perfection in the making
Breast
Breast Augmentation
Breast Implants
Breast Lift
Breast Reduction
Face
Botox
Chin Implant
Chemical Peel
Cheek Implant
Eyelid Surgery
Lip Augmentation
Face Lift
Holistic Treatments
Rhinoplasty
Body
Birthmark Removal
Cellulite Treatment
Liposuction
Tummy Tuck
Others
Sex Change
MTF sex reassignment
FTM sex Reassignment
Dermatology
Dermabrasion
Laser Skin Resurfacing
Tattoo Removal
Mole Removal
Hair Transplantation
Lasik
Medical/wellness spa
Detoxification
Hydrotherapy
Medical Checkup
Meditation
Labiaplasty
Stem Cell Treatment
Dental
Porcelain Veneers
Laser Teeth Whitening
Dental Bridge
Dental Crowns
Dental Fillings
Dental Implant
Denture
Dental Veneers
Root Canal Treatment
Hospitals
Bangkok
Yanhee International Hospital
Piyavate Hospital
Naravee Clinic
PAI Clinic
Kamol Cosmetic Hospital
Bangpakok Hospital
Pattaya
Pattaya International Hospital
Phuket
Phuket International Hospital
Hua Hin
San Paulo Hospital Hua Hin
Prices
Bangkok
Yanhee Hospital
Naravee Clinic
PAI Clinic
Kamol Cosmetic
Bangpakok Hospital
Pattaya
Pattaya International Hospital
Phuket International Hospital
Phuket
Phuket International Hospital
DR. V (Veerawat)
Hua Hin
San Paulo Hospital
Offers
Packages
Payment Plans
Flights
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Form Steps
Personal Information
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Location & Appointment
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Surgery Details
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Medical Conditions
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For Women Only
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Additional Information
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Upload Pictures
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Medical Questionnaire
Note: Please fill in the details correctly for your own safety
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*
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Contact Person in case of emergency
Full Name
E-mail
Phone Number
Phone Number
Address
Next Step
Location
Please select the hospitals that you are interested in.
BANGKOK
Yanhee International
PAI (Dr. Preecha)
Naravee Clinic
Bangpakok 9 International
Samitivej Hospital
MTF Kamol
PHUKET
Phuket Internationals (PIAC)
Dr. V (Veerawat)
SAMUI
Bandon Hospital
Bangkok Hospital
PATTAYA
Pattaya International
Bangkok Hospital
-
HUA HIN
San Paulo Hospital
Request Appointment
Appointment Date
Surgery Date
Fly home on
Surgery Details
Please select the surgery that you are interested in.
FACE
Face Lift
Forehead Lift
Neck Lift
Nose Reshaping
Alarplasty
Tipoplasty
Nose Implants
Eyelid Surgery
Chin Implants
Cheek Implant
Jaw Reduction
BODY
Tummy Tuck
Liposuction
Lipofilling
Buttocks Implants
Arms Lift
Thighs Lift
Brazillian Butt Lift
Acculift
BREAST
Breast Implants
Breast Lift
Breast Reduction
Breast Correction
Male Chest Reduction
VASER
Vaser Lipo
Vaser + Hi-Def
Vaser + Acculift
OTHER
BOTOX
Dental Care
SRS MTF
SRS FTM
LASIK
Gynecology
Hair Transplant
Skin Care
Varicose Vein
Other Surgeries
Questions to the surgeon
What results do you expect?
Medical Conditions
Please state any medical conditions you may have.
Diabetes Problems
Yes
No
Thyroid Problems
Yes
No
Heart Problems
Yes
No
Lung Problems
Yes
No
Blood Pressure Problems
Yes
No
Kidney or Liver Problems
Yes
No
Blood Disorders
Yes
No
History of Cancer
Yes
No
HIV or AIDS
Yes
No
Neurological Problems
Yes
No
Anesthesia Problems
Yes
No
Depression
Yes
No
Previous history of DVT and Pulmonary embolism.
Yes
No
If you have answered YES to any of the above please specify
If you have any medical condition not mentioned above, please specify:
For Women Only
All men please skip to the next step.
Do You Take Birth Control Pills
Yes
No
Are you pregnant now?
Yes
No
Are you planning any more pregnancies?
Yes
No
How old is your youngest child? (Month & year)
When did you last breast feed? (Month & Year)
Additional Information
For your safety please answer truley.
Have you been hospitalized or had surgery within the past 12 months?
Yes
No
If yes, when?
If yes, what was the reason for this?
Do you have implants or any metal objects in body?
Yes
No
If yes, please specify:
Do you have difficulty with healing or scarring?
Yes
No
Do you have any allergies to food, drugs, etc?
Yes
No
If yes, please specify:
List all medications you currently take including dosage for each:
List all vitamins or food/nutritional supplements you currently take:
Have you ever taken a
MAO inhibitor
such as Nardil, Marplan or Parnate?
Yes
No
If yes, when was your last dose?
Have you ever taken an anticoagulant like Coumadin, Heparin, or a daily Aspirin?
Yes
No
If yes, when was your last dose?
Do you smoke?
Yes
No
If yes, how much do you smoke?
If yes, when did you last smoke?
Do you drink alcohol?
Yes
No
If yes, how much do you drink?
Upload Pictures for Evaluation
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